• Title/Summary/Keyword: clinical examination experience

Search Result 147, Processing Time 0.021 seconds

Study on Deficiency-Excess Pattern Questionnaire Development Possibility (허실 변증 설문지 개발 가능성에 대한 고찰)

  • Ryu, Hyun-Hee;Lee, Hae-Jung;Jang, Eun-Su;Lee, Si-Woo;Lee, Gi-Sang;Kim, Jong-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.23 no.3
    • /
    • pp.534-539
    • /
    • 2009
  • Deficiency and excess pattern differentiation is unique characteristic of traditional oriental medicine on diagnosis and treatment. This differentiation is accomplished through pulse, tongue diagnosis and question examination, but most of these processes need to be objectified for efficacious treatment and traditional medicine development. In this study, we developed the deficiency and excess pattern questionnaire for objectification of question examination. The deficiency and excess pattern questionnaire was made out through The Traditional Oriental Medical Literature with Delphi Technique. Patients who visited oriental medical hospital filled out the questionnaire by themselves. Diagnosis of deficiency and excess pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the deficiency and excess pattern questionnaire. (Ordinary health degree, pain pattern, fatigue, weight change, sweating, uncomfortable awareness on chest and abdomen) Deficiency symptoms group acquired internal consistency, but excess symptoms group did not. (Cronbach's ${\alpha}$ > 0.6) There were significant associations between doctor's diagnosis and deficiency and excess symptoms in 'ordinary heath degree', 'voice weakening', and 'chest distress' (p-value < 0.1) There were significant differences between deficiency and excess syndrome patients groups in deficiency questionnaire score but there were no significant differences between deficiency and excess syndrome patients groups in excess questionnaire score. We acquired the internal consistency and significant result of deficiency pattern questionnaire, but we can find out some difficulties in development of the excess pattern questionnaire. These difficulties are associated with insufficiency description of traditional literature and small number of patients diagnosed as excess pattern.

Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.4 no.2
    • /
    • pp.249-263
    • /
    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

  • PDF

Cytologic Diagnosis of Hepatocellular Carcinoma by Fine-Needle Aspiration Biopsy (세침 흡인 생검에 의한 간암의 세포학적 진단)

  • Kim, Ki-Kwon;Chang, Eun-Sook
    • The Korean Journal of Cytopathology
    • /
    • v.1 no.1
    • /
    • pp.18-26
    • /
    • 1990
  • CT guided percutaneous fine-needle aspiration (FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver malignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were reviewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the cause of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows ; 1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell In the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liver malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' experience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic.

  • PDF

Complications of impacted third molar extraction: retrospective study (매복지치 발치 시 발생한 합병증 양상에 대한 후향적 연구)

  • Hwang, Jung-Kook;Kim, Kyung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.36 no.2
    • /
    • pp.119-124
    • /
    • 2010
  • Introduction: Surgical extraction of third molar is one of the most frequently performed procedures in oral and maxillofacial surgery unit as the impacted wisdom teeth could cause various complications. Even though, however, extraction of the impacted wisdom teeth is an obligation for the reason of possible complication even for general practitioners, it has been avoided. Various factors concerning surgical extraction of impacted third molar are considered: general condition of patients, relationship with relative anatomies, aspects of impaction, surgeon's skill. Materials and Methods: The consideration and crossing analysis of these factors with 2,463 patients who visit Dankook University dental hospital to extract those impacted third molar. Results: 1. Gender doesn't affect. 2. Medical problems have more complications. 3. There are more complications in high difficulty index (DI) impacted teeth. 4. When inferior alveolar canal overlap mandibular third molar, complication rate is 26.92%. 5. The most common complication was swelling and pain. 6. There is no statistical difference between the incidence of complication and surgeon's experience. Conclusion: In regard to these results, it seems that clinical or radiological examination can predict potential complications of wisdom teeth, and it is helpful to bear in mind the fact.

Factors Leading to Health Promotion Behavior among the Students in a Nursing School of a University - based on the SAT - (일부 간호 대학생들의 건강증진행위 실천에 영향을 미치는 요인 - SAT 모델을 중심으로 -)

  • Lee, In-Sook;Ham, Young-Lim;Kim, Joo-Hyung;Joe, Seun-Young
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.12 no.1
    • /
    • pp.78-85
    • /
    • 2006
  • Objectives: College students experiences more stress than when they were in high school. The students in nursing college, experience a variety of stress related to clinical practices, the examination for registered nurse license etc. The purpose of this study was to identify the factors that affect the health promotion behavior among the students in a nursing college based on SAT(Social Action Theory). Methods: The study was a cross-sectional design with a convenience sample of 427 students recruited from April to May in 2005. SAT was utilized for the theoretical framework of the study. The instruments used were Profile of Mood Stress, Life Stress Scale for college student, Social Adaptation Scale, Health Knowledge and Health Promotion Lifestyle Profile. Data were analyzed with SPSS 12.0 program. Results: The study showed that grades, moods, and satisfaction of relationship with friends, satisfaction with pocket money made up 29.0% of significant factors related to health promotion behavior among the college students in nursing. Conclusion: It suggests that the known factors need to be taken into consideration when developing the health promotion program for college students in nursing.

  • PDF

THE IMPORTANCE OF THE PROPHYLACTIC NECK DISSECTION IN THE EARLY-STAGE TONGUE CANCER (초기설암치료시 예방적 경부곽청술의 의의)

  • Hong, Chang-Soo;Kim, Chin-Soo;Jang, Hyun-Joong;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.17 no.1
    • /
    • pp.73-81
    • /
    • 1995
  • The poor survival rates of patients with carcinoma of a tongue, despite of modern therapy, is well recognized. One of the most important prognostic factors is status of the cervical lymph nodes. There have been a long-standing debate about the treatment of cervical lymph nodes in early-stage tongue cancer. There are two major treatment opinion. The one is surgical excision of primary tumor with prophylactic neck dissection, simultaneously, and the other is to delay the cervical therapy until cervical lymph node is palpable. Recently we have experienced the early cervical metastasis in three patients who had been diagnosed as a carcinoma of the tongue. They were T1, T2 lesion and no palpable node was found. But histopathologic examination showed the occult metastasis or delayed cervical metastasis was occured. By the review of literature and clinical experience, we could conclude the prophylactic neck dissection offers a better chance for success than therapeutic neck dissection of palpable lymph nodes, in case of oral tongue cancer.

  • PDF

Evaluation of Korean teenagers with temporomandibular joint disorders

  • Lee, Ji-Young;Kim, Young-Kyun;Kim, Su-Gwan;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.39 no.5
    • /
    • pp.231-237
    • /
    • 2013
  • Objectives: This study aims to evaluate the severity and pattern of symptoms exhibited by teenage Korean temporomandibular disorder (TMD) patients. Materials and Methods: Among patients with an association of TMDs, teenage patients (11-19 years) who answered the questionnaire on the research diagnostic criteria for TMD (RDC/TMD) were recruited. Results: The ratio of patients who visited our clinic with a chief complaint of clicking sound (34.5%) or temporomandibular pain (36.6%) at the initial diagnosis (examination) was the highest. In the evaluation of the depression index, 75.8% of the subjects were normal, 12.9% were moderate, and 11.3% were severe. With regard to non-specific physical symptoms (including pain), 66.5% of the subjects were normal, 17.0% were moderate, and 16.5% were severe. Concerning non-specific physical symptoms (excluding pain), 70.6% of the subjects were normal, 14.4% were moderate, and 15.0% were severe. In terms of the graded chronic pain score, high disability (grade III, IV) was found in 9.3% of the subjects. Conclusion: Among teenage TMD patients, a portion have clinical symptoms and experience severe psychological pressure; hence requiring attention and treatment, as well as understanding the psychological pressure and appropriate treatments for dysfunction.

Unusual Location of Esophageal Diverticulum (비전형적인 위치에 발생한 상부 식도 게실)

  • Kim, Tae-Hoo;Heo, Chul-Young;Kim, Beom-Gyu;Kim, Yong-Bok;Park, Il-Seok
    • Korean Journal of Bronchoesophagology
    • /
    • v.15 no.2
    • /
    • pp.87-91
    • /
    • 2009
  • Esophageal diverticulum is a rare entity, the true incidence of which is unknown, mainly because there are usually no clinical symptoms. Most esophageal diverticulum are found incidentally during an endoscopic or radiologic examination. Their classification is based on anatomical location; namely, upper third(Zenker or pharyngoesophageal), middle third(thoracic), or lower third(epiphrenic). Here we report a 52-years-old female presenting with dysphagia and regurgitation. Esophagogram showed esophageal diveticulum at lower cervical esophagus. Its positional aspect, it is different from Zenker's diveticulum. Treatment is surgical via an endoscopic or external approach. In view of the patient's age and anatomical location, various surgical approaches were considered as a therapeutic option for the management. This paper presents our experience in the management of esophageal diverticulum which was unusual location and stapled open resection without sternotomy.

  • PDF

Gastric neurofibroma in von Recklinghausen disease : a cause of upper gastrointestinal bleeding (Von Recklinghausen disease병 환아에서 상부위장관 출혈로 발현한 위의 신경섬유종 1례)

  • Kwon, Bo Sang;Shim, Jeong Ok;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Jung, Seong Eun;Kim, Woo Sun;Kang, Gyeong Hoon
    • Clinical and Experimental Pediatrics
    • /
    • v.49 no.2
    • /
    • pp.203-207
    • /
    • 2006
  • Neurofibromatosis type 1 (von Recklinghausen disease, NF1) involves the central and peripheral nervous systems as well as the skin, bone, endocrine, gastrointestinal and vascular systems. The gastrointestinal neurofibroma associated with NF1 has been infrequently reported. We report our experience with a 15-year-old boy who had a gastric plexiform neurofibroma with upper gastrointestinal bleeding and underwent a tumorectomy because of massive upper gastrointestinal bleeding. We conclude that gastrointestinal bleeding and anemia in the setting of NF1 mandates complete endoscopic examination of the digestive tract to rule out neurofibromas. Surgical resection is the standard treatment.

The Therapeutic Value of Ultrasound-Guided Irrigation in Sialodochitis: A Case Report

  • Ahn, Chi-Hyuk;Auh, Q-Schick;Lee, Yeon-Hee
    • Journal of Oral Medicine and Pain
    • /
    • v.43 no.2
    • /
    • pp.52-55
    • /
    • 2018
  • In the present case study, we reported a female patient with sialodochitis fibrinosa in which a conservative ultrasound (US)-guided irrigation method was used to relieve her symptoms. A 30-year-old female patient visited Kyung Hee University Dental Hospital with chief complaints of persistent swelling and discomfort in the left facial area. Her primary symptom was facial swelling that was accompanied by neuropathological symptoms, such as itching, tingling, and warmth that usually continued for 3 to 4 days. During clinical examination of orofacial area, mild swelling and fever were noted in the left face including parotid region, and mild induration could be felt at the corresponding site; sialadenitis of the left parotid gland was tentatively diagnosed. Herein, we performed intraductal irrigation of the left parotid gland in three times per month and prescribed some medication. Thus, her signs and symptoms have been improved, and she did not experience a recurrence for 12-month follow-up to date. This study can support the usefulness of the US-guided irrigation method to treat the sialodochitis fibrinosa without remarkable side effects.